<p><font face="楷体, 楷体_GB2312, SimKai">         华西医院神外的蔡博文医生，病友们不陌生，他是我们公益网络讲堂垂体瘤系列讲座第36讲的讲师。在 2015年7月份为我们做过 “垂体瘤暨肢端肥大症——诊疗认识及策略思考”一讲，至今浏览量已近6000人次。</font></p><p><font face="楷体, 楷体_GB2312, SimKai">听蔡医生的患教讲座和垂体瘤诊疗的学术交流，总能让人联想起天府之国人杰地灵，想必是厚重的积淀使然。</font></p><p><font face="楷体, 楷体_GB2312, SimKai">                                                                   —-—— 按语</font></p><p><font face="宋体, SimSun">2017.12.30 青菜 </font></p><p style="text-align: center;"><font face="楷体, 楷体_GB2312, SimKai"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec357335e9.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec357335e9.png" style="width: 427px; height: 281px;"></font></p><p style="text-align: left;"><font face="楷体, 楷体_GB2312, SimKai"></font></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">重霾压城、橙色预警的日子，躲进绝少悬浮颗粒物的百级手术间，专心致志工作不失为一个好的选择。</p><p style="text-align: center;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec3b1ddbc5.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec3b1ddbc5.png" style="width: 281px; height: 238px;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec3ca4f4aa.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec3ca4f4aa.png"><font face="楷体, 楷体_GB2312, SimKai"></font><br></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">本周二的一个病例是病史悠久、经历了伽马刀等治疗的颅咽管瘤患者，术中肿瘤颇异常情，与脑底血管神经各种粘连，各种纠缠，困难危险，不一而足。同亚专业的师兄工间休息，闲来掠阵，各种打气、鼓励、讴歌、赞扬。终不敢懈怠，收摄心神，豹眼环睁，费时许久终将肿瘤拿下。</p><p style="text-align: center; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec40097044.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec40097044.png" style="width: 406px; height: 463px;"></p><p style="text-align: left; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec42998b41.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec42998b41.png" style="width: 175px; height: 192px;"> <img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec44f9cf46.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec44f9cf46.png" style="width: 180px; height: 190px;"> <img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec474dc260.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec474dc260.png" style="width: 198px; height: 190px;"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">此节却使我想起了前辈教授转述的、神经外科早年脑动脉瘤手术中颂读伟人语录的逸闻。</p><p style="text-align: left; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec4a11fba1.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec4a11fba1.png"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">先辈创业，筚路蓝缕，不仅工作中的艰难和困苦我们今日难以想见，工作中的鼓动与宣传也别具时代印记，殊非今日的我们所能轻易消受。</p><p style="text-align: center; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec4d0b62ac.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec4d0b62ac.png" style="width: 208px; height: 208px;"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">长身玉立的大丘老师丘禔光教授是华西神经外科的创始人，相貌堂堂，富有才艺，尤其是他对学生仁厚慈祥、对患者富有同情在彼时的华西有口皆碑。惜乎天不假年，英年早逝，斯人已去四十载，华西坝还流传着关于他的传说。</p><p><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec5127f24c.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec5127f24c.png"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">高立达老师是华西前辈教授中集大成者，也是当年最有担当、最为操劳的神经外科医生。高老师是华西著名的才子，曾活跃于上世纪五十年代华西坝的话剧舞台上，绘画、朗诵、作曲、指挥均有涉猎，不过还是在神经外科的手术台上耗费了他最多的心血和才华。</p><p><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec534ee8ac.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec534ee8ac.png"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">下图为四十多年前，高立达教授亲笔书写的鞍区占位手术记录。</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec556bb734.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec556bb734.png"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">早年的脑动脉瘤，诊断远不如今日这般明晰。做手术的器械工具🛠用今天的眼光看来非常粗砺。术者头戴一灯如豆，照向幽深的术野，小片昏黄之外，是危机四伏、险象环生的无尽黑暗。</p><p style="text-align: left; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec583944e4.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec583944e4.png" style="width: 266px; height: 214px;"> <img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec5ad04529.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec5ad04529.png" style="width: 290px; height: 258px;"></p><p style="text-align: left; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;">下图是一百多年前，现代神经外科之父哈维·库欣在专著《垂体及其疾病》中关于垂体瘤手术的场景描绘，上个世纪后半叶华西神经外科的工作情景与此差相仿佛。</p><p style="text-align: left; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec5f12430e.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec5f12430e.png"></p><p style="text-align: left; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec6096ea1d.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec6096ea1d.png"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">手术过程中，支部书记负责文宣，手捧金光闪闪的宝书，因应术中情形，口頌着有強大精神力量的字句。</p><p style="text-align: center; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec62d37e5a.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec62d37e5a.png" style="width: 240px; height: 178px;"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">手术准备时，书记念道：</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">"下定决心，不怕牺牲，排除万难，去争取胜利。"</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">又有：</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">"我赞成这样的口号，叫做一不怕苦，二不怕死。"</p><p style="text-align: center;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec6693bd39.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec6693bd39.png" style="width: 252px; height: 272px;"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">当年科技全面落后，缺乏相应的设备和手段，手术过程举步维艰。动脉瘤不幸提前破裂，鲜血汩汩流出，术野难以分辨，术者紧张万分。</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec69832ffc.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec69832ffc.png"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">此际，响彻医生耳畔的声音是：</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">"我们的同志在困难的时候，要看到成绩，要看到光明，要提高我们的勇气。"</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">"中国人民正在受难，我们有责任解救他们，我们要努力奋斗。"</p><p style="text-align: center; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec6bbe2599.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec6bbe2599.png" style="width: 280px; height: 390px;"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">但在当年的条件下，要控制住汹涌的脑动脉出血、起死回生谈何容易？！患者情况急转直下，灾难发生，终将不治。在场医生心力交瘁，心下黯然，心灰意冷，只有强力支撑着收拾残局。</p><p style="text-align: left;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec6fb832b4.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec6fb832b4.png"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">伟人语录中却也有相应、宽慰的内容：</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">"要奋斗就会有牺牲，死人的事是经常发生的。"</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">"人总是要死的，但死的意义有不同。中国古时候有个文学家叫做司马迁的说过：人固有一死，或重于泰山，或轻于鸿毛。 为人民利益而死的，就比泰山还重。"</p><p style="text-align: center; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec720d90c6.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec720d90c6.png" style="width: 232px; height: 300px;"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">"今后我们的队伍里，不管死了谁，不管是炊事员，是战士，只要他是做过一些有益的工作的，我们都要给他送葬，开追悼会。"</p><p style="text-align: center; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec74fb66ce.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec74fb66ce.png" style="width: 256px; height: 182px;"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">"这个方法也要介绍到老百姓那里去。村上的人死了，开个追悼会。用这样的方法，寄托我们的哀思。"</p><p style="text-align: center; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec7789a91b.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec7789a91b.png" style="width: 280px; height: 207px;"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">红宝书并没有改善患者的预后，强大的精神力量并不能代替对自然规律的研究和认识，不能代替科技的全面发展和进步，更不能取代精良的手术器械和设备，这也许是我们从那个并非久远时代的经历中应该领悟到的。</p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;"><br></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;"><br></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">当年大丘老师曾无奈地自嘲：神经外科是诊断"难死人"，工作"累死人"，效果"气死人"的专业啊！</p><p style="text-align: left;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec79eaa887.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec79eaa887.png"></p><p style="box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; text-align: justify; white-space: pre-wrap;">值得庆幸的是，时代进步，科学昌明，神经外科的发展今非昔比，外科手术更成了理性决策贯穿始终的过程，而过去年代曾经强调的精神和意志的作用渐渐淡出。希望今天的医者，能够在更加平和的氛围中，心无旁骛，更加愉快、更有成就感地工作。</p><p style="text-align: center; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec7c13584c.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec7c13584c.png" style="width: 310px; height: 196px;"></p><p style="text-align: left; box-sizing: border-box; font-weight: 400; font-size: 17px; color: rgb(51, 51, 51); font-family: PingFangSC-light; font-variant-numeric: normal; font-variant-east-asian: normal; white-space: pre-wrap;"><br></p><p style="text-align: left;"><img src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec809ac9b0.png" src="https://xc-tech.oss-cn-beijing.aliyuncs.com/201801171105a5ec809ac9b0.png"></p><p style="text-align: left;">https://www.meipian.cn/10gtrd10</p>